Featured ArtIcle - Vogue

"...says Steven Pearlman, M.D., another Upper East Side Plastic Surgeon, the lower face-lift...and mid-facelift...work best when the patient is in her 40's to 50's. The skin is still young; it has good elasticity." "As we get older, the upper lip loses its firmness and definition" says Pearlman. "As a result, the cupid's bow is lost, leaving an undefined flat line in its place. The lower lip should be at least one-and-a-half to two times the size of the upper lip. People think, Plump [the upper lip] up and you'll look younger, but the key is shape and fullness, not making it fat."

To avoid what he calls "trout lips." Pearlman developed a noninvasive procedure that gives you back the Cupid's bow he calls a symbol of "youth, vitality, and beauty." The edge of the lip is called the vermillion border and the skin above it is called the white roll. As you age, you lose the white roll altogether; the vermillion border is deflated, and there is decreasing "turgor," or substance. To combat this effect, Pearlman injects a small amount of Botox above the border (it relaxes the lines above and the circular muscle around the mouth, but you can still pucker and whistle) and leaves the lower muscle alone. "An active muscle next to an inactive one helps give resistance to the upper lip." He injects a bit more to the peaks of the Cupid's bow and then adds an equally small amount of Restylane to ever so slightly plump up the vermilion border, which also restores the white rim.

The before and after photos are impressive and not remotely scary - unlike, say, the pictures he also shows me of Priscilla Presley and Meg Ryan. The whole thing lasts four to six months, and I think seriously about signing up. ...I ask...what about my eyes? "You could do a series of gentle peels around the eyes with very little downtime." He also recommends maybe a little Juvederm in front of my jowls, and Botox to combat the downturn of my mouth.

The downturn, he tells me, is another classic sign of aging...

"Less is more," he says. "you want to appear natural and refreshed, not 20 years younger." And so we begin, one small tweak at a time.

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